title: Postoperative complications and survival after gastric cancer surgery in patients older than 80 years of age.
abstract: BACKGROUND
  This study sought to identify and evaluate the risk factors of postoperative complications, prognostic factors, and appropriate surgical strategies in elderly patients undergoing surgery for gastric cancer.
  
  
  METHODS
  The medical records of 396 radical gastrectomies conducted from January 2006 to December 2011 were retrospectively reviewed. Surgical results and survival rates were assessed for 60 elderly patients (aged ≥ 80 years) and 336 non-elderly patients (aged < 80 years). The study groups were compared with respect to clinicopathological findings, surgical outcomes, and survival.
  
  
  RESULTS
  Elderly patients underwent gastrectomies with shorter operation time, showed less extensive lymphadenectomy, and had a significant difference in overall survival compared with non-elderly patients, although there was no difference in cause-specific survival among patients receiving curative resection. No significant risk factors affecting postoperative complications were identified in the elderly patients. Number of comorbidities (≥2) (HR, 5.30; 95 % CI, 1.11-25.32; P = 0.037) and TNM stage (≥II) (HR, 12.97; 95 % CI, 1.60-105.38; P = 0.017) were identified as independent prognostic factors in the elderly patients receiving curative resection.
  
  
  CONCLUSIONS
  Age is not an independent prognostic factor for patients receiving curative resection for gastric cancer. Multiple comorbidities may also influence the prognosis of elderly patients. Careful follow-up would improve overall survival for elderly patients.
authors.affiliation: Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matudo, Chiba, Japan, k-mita01@sth-medical.co.jp.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Mita
authors.forename: Hideto
authors.initials: H
authors.lastname: Ito
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Murabayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Asakawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Nabetani
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koizumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fujino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery